急性呼吸窘迫综合征新生儿血清LncRNA NEAT1、miR-129-5p水平与病情程度及预后的关系

Relationship between serum levels of lncRNA NEAT1 and miR-129-5p and disease severity as well as prognosis in neonates with acute respiratory distress syndrome

摘要

目的 探究新生儿急性呼吸窘迫综合征(NARDS)患儿血清长链非编码RNA核富含丰富的转录本1(LncRNA NEAT1)、miR-129-5p表达水平与病情严重程度及预后的关系。方法 选取2021年1月至2023年12月延安市人民医院收治的120例NARDS患儿为观察组,根据病情严重程度分为轻度组、中度组和重度组,根据患儿入院28天内的生存情况分为死亡组和生存组,另选120例同期在我院出生的健康新生儿为对照组。比较分析血清中LncRNA NEAT1、miR-129-5p的水平,多因素Logistic回归分析NARDS患儿死亡的影响因素,受试者工作特征(ROC)曲线分析血清LncRNA NEAT1、miR-129-5p水平对NARDS患儿死亡的预测价值。结果 与对照组相比,观察组血清LncRNA NEAT1水平明显升高,miR-129-5p水平明显降低(t值分别为8.653、20.381,均P<0.001);随着病情的恶化,患儿血清LncRNA NEAT1水平逐渐升高(F=8.783,P<0.001),miR-129-5p水平逐渐降低(F=21.441,P<0.001);死亡组患儿发生胎粪吸入综合征的例数占比及血清LncRNA NEAT1水平明显高于生存组(χ²=6.946,t=6.755,均P<0.05),miR-129-5p水平明显低于生存组(t=6.442,P<0.05);胎粪吸入综合征、LncRNA NEAT1为患儿死亡的独立危险因素(OR=2.859,95%CI:1.352~6.045;OR=2.345,95%CI:1.027~5.352),miR-129-5p为独立保护因素(OR=0.639,95%CI:0.418~0.976);血清LncRNA NEAT1、miR-129-5p以及二者联合预测NARDS患儿死亡的曲线下面积(AUC)分别为0.786、0.791、0.912,二者联合预测优于各指标单独预测(Z_{二者联合-LncRNA NEAT1}=2.143、Z_{二者联合-miR-129-5p}=2.158,P=0.032、0.031)。结论 NARDS患儿血清LncRNA NEAT1水平上调,miR-129-5p水平下调,LncRNA NEAT1为患儿死亡的独立危险因素,miR-129-5p为独立保护因素,二者联合对患儿死亡风险具有更高的预测价值。

Abstract

Objective To investigate the relationship between the expression levels of serum LncRNA NEAT1 and miR-129-5p and the severity and prognosis of children with neonatal acute respiratory distress syndrome (NARDS). Methods A total of 120 neonates with NARDS admitted to Yan'an People's Hospital from January 2021 to December 2023 were selected as the observation group. Based on the severity of the condition, they were divided into mild, moderate, and severe groups. According to the survival status within 28 days of admission, they were further divided into a death group and a survival group. Additionally, 120 healthy neonates born in our hospital during the same period were selected as the control group. The serum levels of LncRNA NEAT1 and miR-129-5p were compared and analyzed. Multivariate logistic regression analysis was performed to identify influencing factors of death in NARDS neonates. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive value of serum LncRNA NEAT1 and miR-129-5p levels for mortality in NARDS neonates. Results Compared with the control group, the observation group showed significantly higher serum levels of LncRNA NEAT1 and significantly lower levels of miR-129-5p (t=8.653 and 20.381, respectively, both P<0.001). As the disease worsened, the serum levels of LncRNA NEAT1 gradually increased (F=8.783, P<0.001), while the levels of miR-129-5p gradually decreased (F=21.441, P<0.001). The proportion of neonates with meconium aspiration syndrome and the serum levels of LncRNA NEAT1 in the death group were significantly higher than those in the survival group (χ²=6.946, t=6.755, both P<0.05), whereas the levels of miR-129-5p were significantly lower (t=6.442, P<0.05). Meconium aspiration syndrome and LncRNA NEAT1 were identified as independent risk factors for neonatal death (OR=2.859, 95%CI:1.352-6.045; OR=2.345, 95%CI:1.027-5.352, respectively), while miR-129-5p was an independent protective factor (OR=0.639, 95%CI:0.418-0.976). The area under the curve (AUC) for predicting neonatal death using serum LncRNA NEAT1, miR-129-5p, and their combination was 0.786, 0.791, and 0.912, respectively. The combined prediction was superior to individual predictions (Z_{combination-LncRNA NEAT1}=2.143, Z_{combination-miR-129-5p}=2.158, P=0.032, 0.031). Conclusion In neonates with NARDS, serum levels of LncRNA NEAT1 are upregulated, while miR-129-5p levels are downregulated. LncRNA NEAT1 serves as an independent risk factor for neonatal mortality, whereas miR-129-5p acts as an independent protective factor. The combination of both biomarkers demonstrates higher predictive value for the risk of neonatal death.

关键词

新生儿急性呼吸窘迫综合征 / LncRNA NEAT1 / miR-129-5p / 病情严重程度 / 预后

Key words

neonatal acute respiratory distress syndrome / LncRNA NEAT1 / miR-129-5p / severity of disease / prognosis

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